Independent medical evaluation of general practitioners' follow-up of sick-listed patients: a cross-sectional study in Norway.
Adult
Cross-Sectional Studies
Female
General Practitioners
/ statistics & numerical data
Humans
Independent Medical Evaluation
Male
Mental Disorders
/ therapy
Middle Aged
Musculoskeletal Diseases
/ therapy
Norway
/ epidemiology
Primary Health Care
/ statistics & numerical data
Sick Leave
/ statistics & numerical data
primary care
quality in health care
rehabilitation medicine
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
18 03 2020
18 03 2020
Historique:
entrez:
21
3
2020
pubmed:
21
3
2020
medline:
20
2
2021
Statut:
epublish
Résumé
The study was designed to examine the sufficiency of general practitioners' (GPs) follow-up of patients on sick leave, assessed by independent medical evaluators. Cross-sectional study SETTING: Primary health care in the Western part of Norway. The study reuses data from a randomised controlled trial-the Norwegian independent medical evaluation trial (NIME trial). The intervention group in the NIME trial: Sick-listed workers having undergone an independent medical evaluation by an experienced GP at 6 months of unremitting sick leave (n=937; 57% women). In the current study, the participants were distributed into six exposure groups defined by gender and main sick leave diagnoses (women/musculoskeletal, men/musculoskeletal, women/mental, men/mental, women/all other diagnoses and men/all other diagnoses). The independent medical evaluators assessment (yes/no) of the sufficiency of the regular GPs follow-up of their sick-listed patients. Estimates from generalised linear models demonstrate a robust association between men with mental sick leave diagnoses and insufficient follow-up by their regular GP first 6 months of sick leave (adjusted relative risk (RR)=1.8, 95% CI=1.15-1.68). Compared with the reference group, women with musculoskeletal sick leave diagnoses, this was the only significant finding. Men with musculoskeletal diagnoses (adjusted RR=1.4, 95% CI=0.92-2.09); men with other diagnoses (adjusted RR=1.0, 95% CI=0.58-1.73); women with mental diagnoses (adjusted RR=1.2, 95% CI=0.75-1.77) and women with other diagnoses (adjusted RR=1.3, 95% CI=0.58-1.73). Assessment by an independent medical evaluator showed that men with mental sick leave diagnoses may be at risk of insufficient follow-up by their GP. Efforts should be made to clarify unmet needs to initiate relevant actions in healthcare and work life. Avoiding marginalisation in work life is of the utmost importance. NCT02524392; Post-results.
Identifiants
pubmed: 32193258
pii: bmjopen-2019-032776
doi: 10.1136/bmjopen-2019-032776
pmc: PMC7202711
doi:
Banques de données
ClinicalTrials.gov
['NCT02524392']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e032776Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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